For some children at the dinner table, it’s simply a matter of picky eating, but for others, it may be a legitimate eating disorder that brings anxiety, extreme weight loss and malnutrition.

To mark Eating Disorder Awareness Week, BC Children’s Hospital is focusing on a relatively unknown condition that only became a recognized diagnosis in 2013: avoidant/restrictive food intake disorder, also known as ARFID.

Dr. Jennifer Coelho, a psychologist at the Vancouver-based hospital, told Black Press Media that in its most serious form, the disorder can cause extreme iron deficiency and gastrointestinal and psychological problems.

“It’s really not picky eating. It’s quite normal for young children to have foods they avoid or not have preference for,” Coelho said.

“It’s different than other eating disorders. [These] kids don’t have issues with how they look, like how those with anorexia or bulimia nervosa may have.”

Children and youth with ARFID will avoid certain foods based on the appearance, brand, smell and texture.

Some children may also become extremely worried about eating outside of their normal routine, like on holidays or at a friend’s house.

“For example, if somebody has an allergic reaction, or gets sick and has a vomiting episode, they become very worried about eating,” Coelho said.

Before being designated as a disorder, most children who were struggling would be diagnosed as having an “eating disorder not otherwise specified.”

Since BC Children’s Hospital started a program five years go, she’s seen children of all ages take part in treatment, some as old as 18 years. The disorder can manifest in adults, too, but is more commonly found in children.

Exactly how many children on average suffer from ARFID in B.C., or Canada, isn’t known at this time. A 2014 study out of Penn State University found that 20 per cent of youth admitted to a day treatment program for eating disorders had similar symptoms of this particular disorder.

“There is some confusion in the community here – people who haven’t heard of it because it is so new,” Coelho said.

A first-of-its-kind treatment manual was created and released in 2018, which Coelho said will help doctors better understand the symptoms of ARFID, and the therapy needed to treat it.

BC Children’s Hospital has also been approved through a grant to survey doctors across the province to identify any knowledge gaps around understanding the disorder.

For parents concerned their child may be more than a picky eater, Coelho said important symptoms to look out for include a child failing to gain weight, nutritional deficiencies, or a struggle with eating interfering with their day-to-day. If there is any concern, she urged parents to visit their pediatrician or family doctor.